Cancrum oris in an adult with human immunodeficiency virus infection: case report

Koech, KJ

doi:10.4314/eamj.v87i1.59953

Cited by 13 publications

(16 citation statements)

References 9 publications

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“…The epidemiology of noma globally is uncertain . Even though most cases have been reported from African countries , the incidence and prevalence of noma in Africa are not clear for several reasons. Firstly, most data have been obtained from retrospective studies based on case reports and not from well‐designed prospective studies.…”

Section: Epidemiology Of Noma In Africamentioning

confidence: 99%

Noma (cancrum oris) in the South African context

Feller

Altini

Chandran

et al. 2013

J Oral Pathology Medicine

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Noma (cancrum oris) is a destructive necrotising disease affecting orofacial tissues predominantly of malnourished young children. It is characterised by a rapid acute onset which usually starts in the mouth, spreads intra-orally destroying soft tissue and bone and progresses to perforate the facial skin, causing disfigurement. Polybacterial anaerobic infection is critical too, but is not alone sufficient for the initiation of noma. Cofactors, first and foremost malnutrition, but also systemic viral and bacterial infections are crucial to the development of noma. A patient with necrotising stomatitis or noma must be admitted to hospital for antibiotic treatment, fluid and electrolytes as well as nutritional supplementation and general supportive treatment. The epidemiology of noma in the South African population is unknown, and the clinicopathological features are poorly characterised. Although worldwide there is no evidence that HIV infection is a strong risk factor for noma, HIV infection may play a substantial role in the pathogenesis of noma in South Africa.

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Section: Epidemiology Of Noma In Africamentioning

confidence: 99%

Noma (cancrum oris) in the South African context

Feller

Altini

Chandran

et al. 2013

J Oral Pathology Medicine

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“…Noma occurs worldwide, and although the mayor incidence of noma corresponds to the geographical distribution of poverty, with most cases reported in Africa, it should not be considered as solely a disease of the developing world; the World Health Organization has received reports of sporadic cases of noma-like disease in adults, from higher-income countries, including North America and Western Europe countries, almost always associated with disorders of the immune system like AIDS in association with human immunodeficiency virus (HIV) infection [1][2][3][4][5][7][8][9][10]. The exact incidence of noma-like disease in adults is unknown [11][12][13].…”

Section: Introductionmentioning

confidence: 99%

“…The exact pathogenesis of noma is not known, but it is believed to be multifactorial, where a complex interaction between severe malnutrition and an overwhelming oral infection, frequently preceded by a viral or bacterial infection that further impairs the immune system, results in tissue destruction via necrotizing toxins and enzymes, with secondary ischemia leading to osteonecrosis [1][2][3]7,10,[14][15][16]. In many cases, the precursor for noma is acute necrotizing ulcerative gingivitis, that has been lately considered to be a marker of immune deterioration [1][2][3]7,15].…”

Section: Introductionmentioning

confidence: 99%

Noma and Noma-like disease in HIV/AIDS patients, a comorbid interaction: A systematic review

Calleros

Castillo-Ventura

Jiménez-Escobar

et al. 2018

J Infect Dev Ctries

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Introduction: Noma is an opportunistic polymicrobial infection that cause necrosis of the mouth and face, with high morbidity and mortality, predominantly affecting malnourished children and persons with debilitating diseases. Cases of noma-like disease in adults, although rare, have been increasingly reported in HIV/AIDS patients particularly in developing countries but also in more developed countries. Methodology: A systematic review of the literature to assess the occurrence and clinical impact of noma and noma-like disease in HIV/AIDS patients was performed on PubMed, Virtual Health Library, Cochrane Library and Google Scholar using the keywords "HIV"[ All Fields] AND "Noma"[All Fields] in December 2016 (years includead for the search: 1985 to 2016). Results: Twenty-four published studies were identified that document the occurrence of noma or noma-like disease in a total of 133 HIV/AIDS children and adult patients in the last 22 years. Although HIV infection is not the principal risk factor for noma, in some regions may play a substantial role in its pathogenesis. The mortality rate for noma-like disease in HIV/AIDS patients was 54.3%, compared to the 15% mortality rate of treated noma patients without HIV/AIDS. Most of the cases have never been on antiretroviral therapy, and their HIV infection was discovered because of the noma-like disease. Conclusions: The syndemic interaction between HIV/AIDS and noma-like disease adversely impacts the severity of the disease and the mortality rate. Noma-like disease, although not yet considered a specific or frequent disease associated with HIV infection, should be considered as an opportunistic infection for AIDS.

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“…Social deprivation and poverty lead to the occurrence of preventable diseases such as noma (Chidzonga and Mahomva 2008). Since noma is related to factors associated with poverty and immune suppression, reducing the incidence of noma can be achieved by improving the SES of the communities, along with preventing HIV infection (Koech 2010). The polybacterial etiology of noma and the role of social factors, such as malnutrition, dehydration, poor sanitation, proximity to diseased livestock, unsafe drinking water, recent viral infections, and immune suppression, including HIV, have been well established (Enwonwu 2006).…”

Section: Nomamentioning

confidence: 99%

Determinants of Oral Diseases in the African and Middle East Region

et al. 2015

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Oral health policies must be developed that emphasize the role of social determinants in health and oral diseases. The aim of this report is to review literature on determinants of oral diseases and apply the concepts to promoting oral health in the African countries in the African and Middle East region (AMER). Structural and proximal determinants of oral diseases are common to those affected by other noncommunicable diseases (NCDs). Oral diseases are also heavily affected by issues of politics, poor health behaviors, underdeveloped health systems, and low oral health literacy. Wide-scale poverty exists in populations in the AMER. Oral health promotion and preventive oral health programs should therefore be integrated with those for general health and use the common risk factor approach (CRFA). Attempts should be made to improve the daily living conditions and reduce the incline of the social gradient. Oral health practitioners should use the CRFA when dealing with determinants of oral diseases and in the design of preventive oral health programs. The detrimental effects of the social determinants of health may be ameliorated by involving both the individual and community. Interventions in health promotion programs in the AMER need more research on the epidemiology of oral diseases and the role played by the social determinants of oral diseases, especially with regard to poverty. The high levels of poverty and low gross domestic product in most countries in the African region make it difficult to fund high-quality, affordable, accessible oral health services.

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Cancrum oris in an adult with human immunodeficiency virus infection: case report

Cited by 13 publications

References 9 publications

Noma (cancrum oris) in the South African context

Noma (cancrum oris) in the South African context

Noma and Noma-like disease in HIV/AIDS patients, a comorbid interaction: A systematic review

Determinants of Oral Diseases in the African and Middle East Region

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